A surgeon at Tygerberg Hospital in Cape Town has performed a first in South Africa. Urologist Dr Danelo du Plessis successfully performed a donor nephrectomy — a surgical procedure to remove a kidney from a living or deceased donor for kidney transplantation — using the da Vinci Xi Robotic platform, a robotic surgery technology.
Dr Danelo du Plessis performing the surgery. Image supplied.
This milestone marks an advancement in making organ donation less invasive for living donors.
Less invasive
This system enables surgeons to operate with exceptional precision through four robotic arms, controlled remotely via an immersive 3D console.
“The surgery exceeded our expectations, completed in under 90 minutes,” says Du Plessis, a senior lecturer and medical specialist in SU’s Division of Urology.
The procedure involved a 45-year-old mother donating a kidney to her 24-year-old daughter.
The robotic platform’s enhanced precision and dexterity enabled the surgical team to take a retroperitoneal approach – a less invasive technique that reduces post-operative pain and allows for faster recovery.
The donor was discharged the following day, and the transplanted kidney immediately began producing urine, indicating that the transplanted organ is functional.
While nephrectomies to remove diseased or damaged kidneys have been performed robotically in South Africa, donor nephrectomy presents significantly greater complexity.
This procedure requires the complete removal of a healthy kidney while preserving the full length of the kidney’s blood vessels, ureter and organ integrity for successful transplantation.
An alternative
Dr Matodzi Mukosi, CEO of Tygerberg Hospital, said: “The successful robotic kidney donor surgery is a first for South Africa and a proud moment for Tygerberg Hospital.
“It reflects the extraordinary skill of our surgical teams and highlights the life-changing impact of medical innovation for our patients and their families.”
Professor Elmi Muller, dean of Stellenbosch University’s Faculty of Medicine and Health Sciences and transplant surgeon, praised the achievement.
“Robotic surgery is a new technology that has been used safely in many parts of the world for procedures like nephrectomies and prostatectomies.
“It is great to see that such innovations can also happen in South Africa.
“In a large consensus meeting around the use of robotic surgery in the field of transplantation at the end of 2024, we found that robotic surgery now provides similar results to standard laparoscopic procedures.”
Robotic surgery is a commonly used alternative to laparoscopic surgery and is regarded as equally effective where the technology is available.
Refined technique
Since 2022, Tygerberg Hospital and Stellenbosch University have operated a comprehensive robotic surgery training programme designed to upskill surgeons and senior trainees in advanced surgical techniques.
Du Plessis has completed 200 robotic procedures, including partial nephrectomies, prostatectomies, and cystectomies.
“When operating on perfectly healthy donors, it is essential to have a refined technique,” explains Du Plessis.
“Living donors make this extraordinary sacrifice purely from altruism – they deserve a safe and minimally invasive procedure. This technology delivers on that promise.”
Professor André van der Merwe, head of urology at Tygerberg Hospital and Stellenbosch University, expressed pride in the surgical team’s achievement.
“This represents another leap forward in surgical innovation.
“I anticipate we’ll see more of these procedures, with many more patients benefiting from this technological advancement."
